<!DOCTYPE html>
<html xmlns:th="http://www.thymeleaf.org"
      xmlns:mo="https://gitee.com/aun/Timo">

<body>
<style>
    .timo-detail-title{
        text-align: center;
        font-size: 18px;
        font-weight: 600 !important;
        color: #333 !important;
    }
</style>
    <div class="timo-detail-page" style="padding: 20px">
        <div class="timo-detail-title">医院陪护服务客户信息登记表</div>
        <table class="layui-table timo-detail-table">
            <tbody>
            <tr>
                <th >服务对象姓名</th>
                <td th:text="${order.patient.name}"></td>
                <th >性别</th>
                <td th:text="${#dicts.keyValue('USER_SEX', order.patient.sex)}"></td>
                <th >出生日期</th>
                <td th:text="${order.patient.birthDate}"></td>
                <th >民族</th>
                <td th:text="${order.patient.ethnicity}"></td>
            </tr>
            <tr>
                <th>家庭住址</th>
                <td colspan="3" th:text="${order.patient.homeAddress}"></td>
                <th>身份证号码</th>
                <td colspan="3" th:text="${order.patient.cardNo}"></td>
            </tr>
            <tr>
                <th>户口所在地</th>
                <td colspan="7" th:text="${order.patient.hukouLocation}"></td>
            </tr>
            <tr>
                <th>生活自理情况</th>
                <td colspan="7" >
                    <th:block  th:switch="${order.ability}">
                        <th:block th:case="1">基本自理</th:block>
                        <th:block th:case="2">半自理</th:block>
                        <th:block th:case="3">完全失能</th:block>
                    </th:block>
                </td>
            </tr>
            <tr>
                <th>病史</th>
                <td colspan="7" th:text="${order.patient.medicalHistory}" >

                </td>
            </tr>
            <tr>
                <th>禁忌</th>
                <td colspan="7" th:text="${order.patient.contraindications}" >-</td>
            </tr>
            <tr>
                <th>婚姻状况</th>
                <td th:text="${order.patient.maritalStatus}"></td>
                <th>家庭人口（人）</th>
                <td colspan="5" th:text="${order.patient.familyPopulation}"></td>
            </tr>
            <tr>
                <th rowspan="2">监护联系人</th>
                <th>姓名</th>
                <td colspan="2" ></td>
                <th rowspan="2">服务对象与监护联系人关系</th>
                <td rowspan="2" colspan="3"></td>
            </tr>
            <tr>
                <th>联系人电话</th>
                <td colspan="2"></td>
            </tr>
            <tr>
                <th colspan="2">服务时间</th>
                <td colspan="6"  >
                    [[${order.timeStart}]]至[[${order.timeEnd}]]
                </td>
            </tr>
            <tr>
                <th colspan="2">服务内容</th>
                <td colspan="6"  >
                    [[${order.projectTitle}]]
                </td>
            </tr>
            <tr>
                <th colspan="2">特殊要求</th>
                <td colspan="6" ></td>
            </tr>
            <tr>
                <th rowspan="5" colspan="2">配偶、子女情况</th>
                <th>姓名</th>
                <th>关系</th>
                <th colspan="3">联系电话</th>
                <td> 备注</td>
            </tr>
            <tr>
                <th></th>
                <th>配偶</th>
                <th colspan="3"></th>
                <td></td>
            </tr>
            <tr>
                <th></th>
                <th>子女</th>
                <th colspan="3"></th>
                <td></td>
            </tr>
            <tr>
                <th></th>
                <th></th>
                <th colspan="3"></th>
                <td></td>
            </tr>
            <tr>
                <th></th>
                <th></th>
                <th colspan="3"></th>
                <td></td>
            </tr>



            </tbody>
        </table>

    </div>
</body>
</html>